Texas Health Arlington Memorial Hospital — price list

← Hospital overviewVerified from Texas Health Arlington Memorial Hospital’s published price file

Includes cash prices, list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Showing the first 1,500 prices from a large file. Search a procedure or code below to narrow the list.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

14 prices shown (filtered).

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
ALIROCUMAB 75 MG/ML SUBCUTANEOUS PNIJ [130007] Inpatient	J3490 HCPCS	$1,848	$1,109	$639 – $1,739	—
AMIKACIN 500 MG/2 ML INHALATION SOLN [300741] Inpatient	J0278 HCPCS	$55.88	$33.53	$19.32 – $52.58	—
DEXTROSE 10 % IN WATER (D10W) 10 % IV PUSH [300786] Inpatient	0258 RC	$50.00	$30.00	$17.29 – $47.05	—
DOBUTAMINE 250 MG/20 ML (12.5 MG/ML) INTRAVENOUS SOLN [100075] Inpatient	J1250 HCPCS	$31.62	$18.98	$10.93 – $29.75	—
DOBUTAMINE IN D5W 250 MG/250 ML (1 MG/ML) INTRAVENOUS SOLP [100078] Inpatient	J1250 HCPCS	$50.00	$30.00	$17.29 – $47.05	—
FENTANYL CITRATE-0.9%NACL (PF) 1,500 MCG/30 ML INFUSION [300745] Inpatient	J3010 HCPCS	$144	$86.57	$49.89 – $136	—
HEPARIN (PORCINE) IN NACL (PF) 1,000 UNIT/500 ML IRRIGATION SOLN [300769] Inpatient	J1644 HCPCS	$50.00	$30.00	$17.29 – $47.05	—
HEPARIN (PORCINE) IN NACL (PF) 2,000 UNIT/1,000 ML IRRIGATION SOLN [300774] Inpatient	J1644 HCPCS	$50.00	$30.00	$17.29 – $47.05	—
HYDROMORPHONE IN 0.9 % NACL 30 MG/30 ML INFUSION [300708] Inpatient	J1170 HCPCS	$65.66	$39.40	$22.71 – $61.79	—
KETAMINE 50 MG/ML NASAL SOLN [300799] Inpatient	0250 RC	$12.50	$7.50	$4.32 – $11.76	—
LIDOCAINE-EPINEPHRINE-TETRACAINE [300076] Inpatient	0250 RC	$15.20	$9.12	$5.26 – $14.30	—
MIDAZOLAM IN 0.9 % NACL 30 MG/30 ML INTRAVENOUS INFUSION [300734] Inpatient	J2250 HCPCS	$50.00	$30.00	$17.29 – $47.05	—
NORMAL SALINE FLUSH FOR TPA [300779] Inpatient	0258 RC	$50.00	$30.00	$17.29 – $47.05	—
OXYTOCIN IN LACTATED RINGERS 30 UNIT/500 ML (ML/HR) INTRAVENOUS SOLN [300729] Inpatient	J2590 HCPCS	$109	$65.10	$37.52 – $102	—